PURPOSE: To compare the effect of medial rectus recession in consecutive esotropes who had previous monocular medial rectus resection and lateral rectus recession and in non- accommodative esotropes (NAET) with small angle of deviation who had no prior operation. METHODS: We studied the results of unilateral medial rectus recession at postoperative 2 and 6 months in 7 consecutive esotropes and 19 NAET with deviation angle around 20 PD, and analyzed the corrected amount for 1 mm medial rectus recession. We regarded deviated angle of+/-8 PD at orthophoria as successful operation. RESULTS: The abosolute value of remained deviation in consecutive esotropes and NAET were 4.86+/-5.67 PD and 9.05+/-3.95 PD at postoperative 2 months, and 5.42+/-7.89 PD and 8.26+/-4.45 PD at postoperative 6 months, respectively. There were significant differences between at postoperative 2 and 6 months (p<0.05). The success rates in consecutive esotropes and NAET at postoperative 2 months were 86% and 42%, and 71% and 47%, respectively at postoperative 6 months, which were no significant differences (p>0.05). The average amount of corrected deviation for 1 mm recession at postoperative 6 months was 5.84 PD in consecutive esotropes and 2.97 PD in NAET, which were significant differences (p<0.05). CONCLUSION: Unilateral medial rectus recession in consecutive esotropes may be a useful and first choice of operation procedure when considering second operation. The amount of correction for 1 mm medial rectus recession is larger in consecutive esotropes than in NAET, possibly due to previous resection of medial rectus or release of fat adhesion. Therefore the amount of medial rectus recession in consecutive esotropia should be determined after considering the degree of abduction and operative findings.
Esotropia*

Preoperarive measurement of strabismic angle is most important procedure in determining the amount of surgery.But measured angles are not always the same at each examination, which is quite a steress to both the operator and the patient because additional examination has to be done for accurate determination of surgical amount and also because the confidence for planned amount of surgery may be reduced.Therefore we investigated the variance of preoperative measurements and evaluated the necessity of repeated examinations. We compared the variance of measurement and investigated the bias and reliability of repeated examinations, from 104 patients who were examined initially by a resident at first visit and examined repeatedly at least 3 times before operation by a specialist.Also, the degree of variance in measurement and its relation with postoperative result were evaluated. The differences in measurement between resident and specialist was average 2.37 prism diopters, which was not significant on reliability analysis.Also, there were no significant differneces among 3 measurements by specialist. The degree of variance decreased with increasing age and the larger the degree of variance in measurement, the larger the deviation which may be remained postoperatively. The results suggest that the angle of deviation measured by resident is reliable and repeated measurements do not differ significantly[p>0.05], and also confirms that the variation of these measurements is an important factor which can influence postoperative results.
Bias (Epidemiology) ; Exotropia* ; Humans ; Specialization

Patau syndrome, a trisomy of number 13 chromosome, is a rare congenital chromosomal anomaly accompaing many abnormalities of cardiovascular and central nervous system, kidney and extremity, face and eye. We experienced a case of Patau syndrome in newborn infant who had bilateral microphthalmia, microcornea, corneal opacity, iris coloboma, cataract, dislocated lens, spherophakia, retianl fold and dysplasia, which are typical ocular anomalies of this syndrome previously described overseas but not reported in domestic. So, we report this case with a review of the literatures.
Cataract ; Central Nervous System ; Coloboma ; Corneal Opacity ; Extremities ; Humans ; Infant, Newborn ; Iris ; Kidney ; Microphthalmos ; Trisomy

PURPOSE: The purpose of this study was to analyze the ultrasonographic (USG) findings of Kikuchi cervical lymphadenopathy in pediatric patients. METHODS: Between April 2007 and September 2016, 84 children (42 male and 42 female; mean±standard deviation age, 12.9±3.2 years; range, 5 to 18 years) confirmed with Kikuchi disease were enrolled. Clinical findings and USG findings of Kikuchi cervical lymphadenopathy were retrospectively reviewed. Localized symptoms, systemic symptoms, and laboratory findings including the white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed. An analysis of the USG findings included evaluation of the location, size, and presence of intranodal abscess; intranodal calcification; perinodal fat swelling; localized fluid collection; and loss of nodal echogenic hilum. RESULTS: Among the patients, 49 (58%) showed localized tenderness at the cervical lymphadenopathy. Fever was present in 55 (66%), while 27 (32%) had prolonged fever. Of 74 with lab results, 54 (73%) had leukopenia but none had leukocytosis. Among the same 74, there was a high ESR (>50 mm/hr) in 10 (14%) and a high CRP level (>5 mg/dL) in seven (9%). The USG findings of most of the patients (n=72, 86%) showed unilateral neck involvement, especially in the left side neck (45 of 72, 63%). The most common site of Kikuchi lymphadenopathy involvement was the area at cervical lymph node level V, at the posterior triangle (n=77, 92%). Conglomerated nodal distribution (n=57, 68%), preserved central nodal echogenic hilum (n=84, 98%), and perinodal fat swelling (n=55, 65%) were common USG findings in the children with Kikuchi. In addition, multiple cervical lymph nodes showed a relatively even size distribution (n=73, 87%). CONCLUSION: The common USG findings of Kikuchi disease in the pediatric population of our study were multiple conglomerated unilateral cervical lymphadenopathy showing perinodal fat swelling and even size distribution.
Abscess ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Leukocyte Count ; Leukocytosis ; Leukopenia ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Neck ; Pediatrics ; Retrospective Studies ; Ultrasonography

Sinusoidal hemangioma is a rare variant of cavernous hemangioma. Clinically, it develops in adults and predominantly in females, and presents as a solitary painless subcutaneous nodule. Histological finding of the sinusoidal hemangioma shows a well-circumscribed lobular architecture in the subcutaneous tissue. The lobulated mass is composed of dilated sinusoidal thin-walled vascular channels, which have a pseudopapillary pattern and back-to-back arrangement without much intervening stroma. We report a case of sinusoidal hemangioma which can be differentiated from the other vascular tumors and has never been reported in Korea.
Adult ; Female ; Hemangioma* ; Hemangioma, Cavernous ; Humans ; Korea ; Subcutaneous Tissue

PURPOSE: To determine patient's use of alternative cancer therapies, as well as the characteristics of the patients who used these therapies, descriptive study was conducted at the one college hospital in Seoul. MATERIALS AND METHODS: Of 950 eligible patients who discharged from October 1, 1996 to Febrary 28, 1997, 283 patients were completed semistructured questionnaire telephone survey finally(response rate is 29.8%). RESULTS: Alternative therapies were used by 53.0% of patients. The preferred was dietary therapies and oriental(herbs, acupucture) therapies, folk therapies, drug therapies were other popular methods. Any patient characteristics except time prolongation after diagnosis were not associated with use of alternative therapies. The patients were seeking for alternative therapy because they thought conventional medical treatments were not enough to expect to improve their health, The major source of information was relatives and friends, not the mass media. 46.6% of the patients used althenative therapy said that it were not effective but 30.4% of them said it would help to slow the progression of their disease or strengthen their resistance. 45.0% of them were satisfied with it. CONCLUSION: A significant proportion of cancer patients use one or more forms of alternative therapy. The physicians should recognize and give due consideration to the patients underlying desire for better control of his disease, and should be able to advise his patients on the use of alternative therapy.
Complementary Therapies* ; Diagnosis ; Drug Therapy ; Friends ; Humans ; Mass Media ; Surveys and Questionnaires ; Seoul ; Telephone

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: A variety of biodegradable polymers have been utilized to fabricate matrices for engineering genitourinary tissues, Chitosan is a biosynthetic polysaccharide that is the deacetylated derivative of chitin. The aims were to investigate the characteristics of the newly developed porous chitosan-based biodegradable scaffolds and to reconstruct cavernosal smooth muscle structure in vivo. MATERIALS AND METHODS: To study the cytotoxicity of the newly developed scaffolds, cultured L929 murine fibroblasts were stained with PKH-26 and then cultured on culture plate or loaded in chitosan/hyaluronic acid polymers. For in vivo study, human corpus cavernosal smooth muscle cells were seeded on the scaffolds at concentration of 20*106 cells per cm3 .A total of 24 polymer scaffolds were implanted subcutaneously with cells in one side and without cells in the other side, respectively, in 12 athymic mice, Mice were scarificed 7, 14, 28 days after implantation, respectively. H-E stain and monoclonal anti-alpha smooth muscle actin stain were performed. RESULTS: Scanning electron micrographs of chitosan and 0.03% hyaluronic acid based scaffolds showed sheet-like porous structure. The cell division numbers of L929 murine fibroblasts sere significantly increased in scaffolds by chitosan/hyaluronic acid compared with chitosan alone, Histologically the retrieved polymers seeded with cavernosal smooth muscle cells showed organized smooth muscle structure 28 days after implantation. immunohistochemical analysis confirmed the smooth muscle phenotype. CONCLUSION: These results show that porous chitosan-based biodegradable scaffolds are new biomaterials for the reconstruction of cavernosal smooth muscle structure. However, further studies are needed to make cavernosal sinusoidal structure using this new scaffolds.
Actins ; Animals ; Biocompatible Materials ; Cell Division ; Chitin ; Chitosan ; Fibroblasts ; Humans ; Hyaluronic Acid ; Male ; Mice ; Mice, Nude ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; Penis ; Phenotype ; Polymers ; Tissue Engineering